Prison doctor no stranger to controversy

Dr. James Heinrich performs a prenatal exam on a pregnant inmate, filmed for the 2007 documentary "Lockdown: Women Behind Bars," at Valley State Prison for Women in Chowchilla, Calif. The OB-GYN ordered tubal ligations without state approval and is responsible for hundreds of other inmate sterilizations. CREDIT: National Geographic

Dr. James Heinrich performs a prenatal exam on a pregnant inmate, filmed for the 2007 documentary "Lockdown: Women Behind Bars," at Valley State Prison for Women in Chowchilla, Calif. The OB-GYN ordered tubal ligations without state approval and is responsible for hundreds of other inmate sterilizations. CREDIT: National Geographic

A prison doctor investigated by theCalifornia medical board after ordering tubal ligations without state approval is responsible for hundreds of other inmate sterilizations, The Center for Investigative Reporting has found.

Dr. James Heinrich also has a history of medical controversies and expensive malpractice settlements both inside and outside prison walls. Female patients have accused him of trying to dictate their reproductive decisions, unsanitary habits and medical malpractice.

Despite that history, Heinrich was not only hired by the prison system, but also kept on once a federal judge appointed a receiver to clean up the prison’s medical system.

Heinrich, 69, retired from Valley State Prison for Women in 2011 after six years. Federal authorities rehired Heinrich as a contract physician, and he continued treating inmates at Valley State though December 2012.

An earlier CIR investigation, published in July, found that more than 100 tubal ligation surgeries took place without the required state approval from 2006 to 2010. At the time, prison documents indicated there were 148 of those surgeries. Analysis of subsequent data and documentation provided under the state Public Records Act shows there were 132 because some were double counted.

The women were signed up for the surgery while pregnant at the two women’s prisons that house pregnant inmates, the California Institution for Women in Corona and Valley State Prison for Women in Chowchilla. Valley State became a men’s prison in 2013.

Newly obtained state prison data indicates that more than halfof those surgery referrals – 74 – were made at Valley State. More than two-thirds of those referrals came from Heinrich or a nurse on his staff, according to the prison’smedical service request records.

Heinrich previously told CIR that the money spent sterilizing inmates was minimal “compared to what you save in welfare paying for these unwanted children – as they procreated more.”

The fuller profile of Heinrich emerged from interviews and a review of hundreds of pages of court, medical and prison files and contracting and cost data.

In addition to tubal ligations, Heinrich arranged other types of sterilizations 378 times from 2006 to 2012. These included hysterectomies, removal of ovaries and a procedure called endometrial ablation, which destroys the uterus’s lining.

Although these sterilizations are not banned in California prisons, the quantity attributed to Heinrich ultimately caused federal administrators to take note, said Dr. Ricki Barnett of the federal receivership.

The California Department of Corrections and Rehabilitation hired Heinrich in December 2005 to head obstetrics and gynecology at Valley State. A few months later, U.S. District Judge Thelton Henderson of the Northern District of California appointed a receiver to take over inmate health care after ruling that the state’s medical treatment of prisoners violated the constitutional ban on cruel and unusual punishment.

Overall, the number of sterilization surgeries sharply increased after Heinrich joined the prison system.

From 2006 to 2008, Valley State averaged 150 sterilization surgeries of all types annually – six times that of the Central California Women’s Facility, the largest women’s prison in the state.